Objective To explore the indication,technique and complications of Snodgrass operation in hypospadias repairment.Methods From Sep.2005 to Nov.2006,22 boys from 2 to 18 years old with hypospadias were treated with Snodgrass modification.The procedure was performed in 16 patients as a primary repairment and in 6 patients as the 2-stage repairment.The entire length of the urethral plate was incised along the midline in primary repairment,and the skin flaps and residual urethral plate were incised in the 2-stage repairment.The length of neourethra was from 1 to 10 cm.The neourethra was tubularized over a F 6 or F 8 catheter.The urethral stent was removed in 10 to 14 days pos-toperatively.Results Of the 22 patients,18(81.8%) required no other surgery as the repairment provided a normal appearing penis(straight,terminal meatus, cosmetics) without complications.Fistul aoccurred in 4 patients(18.2%) and meatal stenosis in 1 patient.Conclusion Snodgrass operation creates a vertical slit-like neomeatus.The procedures restores good function and normal appearance to the penis.

Objective To compare the curative effects of CT-guided ethanol injection and lauromacrogol injection into the sac cavity in treating ovarian endometriosis cysts. Methods A total of 86 patients with ovarian endometriosis cyst were enrolled in this study. The patients were divided into ethanol group (n=44) and lauromacrogol group (n=42). Under CT guidance, injections of ethanol or lauromacrogol into the sac cavity of ovarian endometriosis cysts were respectively performed for the patients of both groups. The patients were followed up for six months, and the curative effects and the complications were analyzed. Results Six months after the treatment, the cure rates of ethanol group and lauromacrogol group were 95.50%and 92.86%respectively, and no statistically significant difference in cure rate existed between the two groups (P>0.05). The preoperative serum CA125 levels of the ethanol group and lauromacrogol group were (48.42±23.68)μg/L and(49.21±22.83) μg/L respectively, and the post operative ones were (23.56±5.89) μg/L and (25.49± 6.10) μg/L respectively; the differences between the preoperative data and the postoperative data were statistically significant in both groups (P<0.05), although the differences in serum CA125 levels between the two groups were not significant (P>0.05). The incidence of postoperative complications in the lauromacrogol group was obviously lower than that in the ethanol group (P<0.05). The cure time in the ethanol group was shorter than that in the lauromacrogol group, although the difference was not significant after six months. Conclusion For the treatment of ovarian endometriosis cysts, CT-guided lauromacrogol injection into the sac cavity has reliable curative effect. Compared to ethanol injection, injection of lauromacrogol is safer and has fewer adverse reactions. Therefore, this technique should be recommended in clinical practice. Serum CA125 can be used as an indicator for the evaluation of curative effect.

25 mmHg) had no response to conservative management, and,therefore,had to be decompressed by invasive procedure,including 6 patients performed by decompression laparotomy,2 patients by laparoscopic decompression and 5 patients by ultrasound/computed tomography location and needle paracentesis drainage.These 13 ACS patients had obvious amelioration in physiological variables (hemodynamic,respiratory and tissue perfusion) after 24 hour post-decompression (P

Diagnosis, Differential ; Humans ; Medicine, Chinese Traditional

Humans ; Nanoparticles ; toxicity ; Skin ; drug effects ; Skin Absorption

AIM: To investigative the inhibitory effects of Paecilomyces cicadae polysaccharide (PcPS) against HBV in vitro, and the effects on the Toll like receptor 4 (TLR4) mRNA expression in HepG2.2.15 cell strain. METHODS: HepG2.2.15 cell strain was co-cultured in vitro with PcPS in different concentrations, and lamivudine (LMV) was applied as positive control. MTT assay was employed to detect the cytotoxicities of PcPS in vitro, when the HepG2.2.15 cells was used as target cells. The effects of PcPS on the secretion of HBsAg and HBeAg were assayed by ELISA method. Fluorescence quantitative-PCR (FQ-PCR) was used to detect the inhibitory effects of PcPS on the content of HBV-DNA and TLR4 mRNA in HepG2.2.15 cells. RESULTS: The inhibitory effects of PcPS on the HBsAg and HBeAg were observed and the maximum inhibitory ratio up to 44.8% and 31.0%, respectively. The same inhibitory effects of PcPS on the HBV-DNA replication and TLR4 mRNA expression in HepG2.2.15 cells were also found. CONCLUSION: A certain concentration of PcPS significantly inhibits HBV replication in vitro.

ObjectiveTo investigate the efficacy of transurethral resection and ball pouch dilatation for treatment of ureterostenosis.MethodsThe clinical data of 49 cases of ureteral stricture were analyzed retrospective analysis from June 2008 to June 2011 with 20 cases of male patients and 29 cases of female patients.The age was 15 to 56 years,with a mean age of 40 years.Ipsilateral renal function were mild impairment in 4 cases,moderate impairment in 35 cases,and severe damage in 10 cases.There were ureteropelvic junction etenosis in 11 cases,upper ureteral stricture in 13 cases,and lower segment stenosis in 25 cases.The ureteral stricture length was 0.3 to 2.0 cm,with a mean of 1.2 cm.Seventeen patients were treated with transurethral resection and ball pouch dilatation by minimally invasive percutaneous nephrostomy,and 31 cases were completed by ureteroscopy.The ureteral stents were removed by ureteroscope after 3 - 6 months.45 cases were followed up for 12 -43 months,with a mean of 24 months. ResultsForty-eight cases were completed smoothly with 1 case converted to open surgery.The surgical time was 25 to 95 min with a mean of 42 min.The postoperative hospital stay was 2 to 6 d with a mean of 4 d.In the follow-up of 45 cases,B ultrasound and CT scan showed hydronephrosis reduced significantly in 39 patients,IVU showed unobstructed ureter without significant stenosis.And 6 cases showed no significant changes in hydronephrosis. Conc(t)usionThe method of transurethral resection and ball pouch dilatation has good clinical effect,less pain and shorter hospital stays,which provides a new and effective treatment for patients with ureteral stricture.

Objective To observe the effect of polyethylene terephthalates (PET) coated with 58S bioactive glass on graft-bone healing.Methods The PET coated with 58S bioactive glass was used in experimental group,and uncoated PET was used as a control.The coating solution was made of 20％ bioactive glass powder and 80％ gelatin powder (by weight).In our vitro study,4×104/ml MT3T3-E1 cells were cultured in 24-well plates with the coated or uncoated PET,and the MTT and ALP were tested at 1,3,5 days to show the proliferation and the activity of the cells.The SEM and the X-ray photoelectron spectrometer were adopted to analyze the surface characteristics of the fiber.In our vivo study,24 skeletally mature New Zealand white rabbits were randomly divided into two groups,the 58S-PET group and the PET group.Both groups underwent a surgical procedure to establish a tibia-articular tendon-bone healing model.Mechanical examination and histological assay were taken to verify the coating effect in vivo.Results The 58S-PET group showed significantly differences in both the MTT and ALP tests at each time point (3,5 days) compared with the PET group.In the animal experiments,the maximum load increased by time in both groups.At 6 weeks,the load-to-failure was significantly higher in the 58S-PET group [(61.70±6.95) N]than that of the PET group [(45.21±9.78) N].At 12 weeks,the load-to-failure was also significantly higher in the 58S-PET group [(89.25±9.50) N]than that of the PET group [(71.38±6.26) N].In the histological assay,it was found that there was new bone formation in the indistinct interface between the graft and the host bone in both groups at 6,12 weeks,and a stronger binding was seen in the 58S-PET group than in the PET group.Conclusion The 58S-PET could enhance the proliferation and activity of the osteoblast and therefore promote the new bone formation and subsequently leads to a positive effect on tendon-bone healing.

Objective To investigate the effect of flurbiprofen axetil on perioperative plasma levels of prostaglandin E2 (PGE2) and β-endorphine (β-EP) in patients after remifentanil-based anesthesia.Methods Sixty ASA Ⅱ patients of both sexes,aged 40-64 yr,weighing 50-75 kg,undergoing resection of esophageal cancer,were randomly divided into 3 groups (n =20 each):intralipid group (group A),flurbiprofen axetil pretreatment + postoperative analgesia with flurbiprofen axetil group (group B) and flurbiprofen axetil pretreatment group (group C).Anesthesia was induced with propofol,remifentanil and rocuronium and maintained with propofol,remifentanil and intermittent iv boluses of rocuronium.In group A,intralipid 0.2 ml/kg was injected intravenously at 30 min before operation and patient-controlled intravenous analgesia (PCIA) with fentanyl 15μg/kg + intralipid 0.2 ml/kg was used for postoperative analgesia.In group B,flurbiprofen axetil 2 mg/kg was injected intravenously at 30 min before operation and PCIA with fentanyl 15 μg/kg + flurbiprofen axetil 2 mg/kg was used for postoperative analgesia.In group C,flurbiprofen axetil 2 mg/kg was injected intravenously at 30 min before operation and PCIA with fentanyl 15 μg/kg + intralipid 0.2 ml/kg was used for postoperative analgesia.PCIA solution contained fentanyl 15 μg/kg,flurbiprofen axetil 2 mg/kg and intralipid 0.2 ml/kg in 100 ml of normal saline.The PCA pump was set up with a 0.5 ml bolus dose,a 10 min lockout interval and background infusion at a rate of 2 ml/h after a loading dose of 5 ml starting from 30 min before the end of operation.VAS score was maintained ＜ 3 after operation,and tramadol 50 mg was injected intravenously when VAS ≥ 4 after operation.The amount of remifentanil used during operation and the number of successfully delivered doses and the number of attempts,requirement for tramadol,apnea and severer hypotension were recorded within 48 h after operation.Blood samples were taken immediately before induction of anesthesia,at the end of operation,24 and 48 h after operation (T1-4) for determination of plasma β-EP and PGE2 concentrations.Results There was no significant difference in the amount of remifentanil used among the three groups (P ＞ 0.05).Compared with group A,the number of successfully delivered doses,the number of attempts and the requirement for tramadol were decreased,and the concentration of plasma PGE2 at T2,3 were significantly decreased in groups B and C,and the concentrations of plasma β-EP at T3,4 in group B and at T4 in group C were significantly increased (P ＜ 0.05).Compared with group B,the number of successfully delivered doses,the number of attempts and requirement for tramadol were significantly increased,and the concentration of plasma β-EP at T3,4 wassignificantly decreased in group C (P ＜ 0.05).Compared with the baseline value at T1,the concentrations of PGE2 were significantly increased at T2,3,and the concentration of plasma β-EP was significantly increased at T2,but decreased at T4 in group A,and the concentrations of β-EP at T3,4 were significantly increased in group B (P ＜ 0.05).There was no significant difference in the concentrations of PGE2 and β-EP between the four time points in group C (P ＞ 0.05).Apnea and severer hypotension were not found in the three groups.Conclusion The mechanism by which flurbiprofen axetil reduces postoperative opioid tolerance in patients after remifentanil-based anesthesia may be related to the decrease in PGE2 levels and increase in β-EP levels.

Objective To explore the clinical utility of fluorescence in situ hybridization (FISH) urine test as a non-invasive method for diagnosing the upper urinary tract urothelial carcinoma (UUTUC).Methods Urine specimens from 30 consecutive patients with UUTUC were analyzed by means of FISH and cytology.Ultrasonic and CT were also used to analyze urine specimens from the study group.Urine specimens from 30 patients with other diseases were also analyzed by means of FISH and cytology in order to compare the specificity.Results The sensitivities of FISH,cytology,CT and ultrasonic were 87％,37％,90％ and 43％.The specificity of FISH and cytology were 97％ and 93％.The sensitivity between FISH and MMCT were compared and they were not statistically significantly superior to ultrasonic and cytology.FISH and cytology were compared and no specific statistical significance was found.The positive and negative predictive value for FISH was 96％ and 88％.For cytology it was 85％ and 60％.Conclusions FISH analysis is a useful ancillary test in the detection of UT-TCC with excellent sensitivity and specificity.It provides a more reliable and less invasive approach to diagnosis and postoperative follow-up for UT-TCC.